NPI | 1003459850 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA64770) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61222152) |
Enumeration Date | 2019-10-24 |
Last Update Date | 2024-09-23 |